阿达木单抗联合甲氨蝶呤治疗类风湿关节炎的疗效研究

摘要

Objective:To evaluate the efficacy and safety of adalimumab (ADA) and methotrexate (MTX) treatment for rheumatoid arthritis (RA).Methods:203 cases of RA patients selected from our hospital were randomly divided into MTX monotherapy group,and ADA combined with MTX treatment group.The clinical data and the laboratory indexes of patients were detected.The clinical features and incidence of adverse reactions were compared.Results:The ADA-MTX group had higher total effective rate and higher ratio of the patients who had decrease of VAS score,relief of swell and remission of pressing pain than the MTX group (P ＜0.05).Compared with MTX group,ADA-MTX group at 12 weeks and 24 weeks had such clinical characteristics (time of morning stiffness,joint pressing pain number,number of swollen joints and DAS28 scores) decreased significantly,and the difference was statistically significant (P＜0.05).Compared with MTX group at 24 weeks,the scores of quality of life of patients were significantly improved in group ADA-MTX,and the difference was statistically significant (P＜0.05).There was no significant difference in incidence of adverse reactions between ADAMTX group and MTX group (12.7％ vs.14.9％,P=0.651).Conclusions:Adalimumab combined with methotrexate in treatment of rheumatoid arthritis could significantly improve the laboratory indexes,clinical signs and symptoms of the patients.It also could improve the quality of life and reduce dysfunction of patients,showing good tolerance and safety.%目的:评估阿达木单抗(ADA)联合甲氨蝶呤(MTX)治疗类风湿关节炎(RA)的疗效与安全性.方法:选取在我院风湿科治疗的203例RA患者,将患者随机分为MTX单药治疗组(MTX组,n=101)与ADA联合MTX(ADA-MTX组,n=102)治疗组.记录患者的临床资料,检测患者实验室指标,比较患者的临床特征与不良反应发生率.结果:ADA-MTX组患者肿胀减轻、VAS评分降低、压痛减轻的患者比率与总有效率显著高于MTX组,差异有统计学意义(P＜0.05).与MTX组比较,ADA-MTX组第12周、24周临床特征(晨僵时间、关节压痛数、关节肿胀数与DAS28评分)显著下降,差异有统计学意义(P＜0.05).与MTX组第24周值比较,ADA-MTX组患者的生活质量评分显著提高,差异有统计学意义(P＜0.05).ADA-MTX组与MTX组不良反应发生率比较无统计学差异(12.7％ vs 14.9％,P=0.651).结论:阿达木单抗联合甲氨蝶呤可明显改善类风湿关节炎患者实验室指标与临床体征、症状,从而减少患者功能障碍,提高患者生活质量,且具有良好的耐受性与安全性.